Hypotensive Effect of Topical Brimonidine Tartarate on Intra-Ocular Pressure Spikes Following Intravitreal Injection of Ranibizumab

Objective: To study the effect of topical Brimonidine 0.2% eye drops (Brimonidine Tartarate) prophylaxis on intraocular pressure (IOP) spikes following intravitreal injection of Ranibizumab (Lucentis) 0.5mg/0.05ml.
Methods: This is randomized comparative conducted on one hundred non-glaucomatous eyes of one hundred patients. The candidates who were enrolled in the study were randomly classified into two groups; each of which consisted of 50 eyes, fifty eyes with odd and even file numbers. Those with odd file numbers (group A) have not received topical brimonidine tartarate while those with even file numbers have received pre injection topical brimonidine tartarate twenty minutes before the intravitreal injection (group B).
Results: A significant IOP rise was reported in the injected eyes after 30 minutes, and one day after injection (with a mean of 17.58 ± 3.18 mmHg and17.12±2.11 mmHg at 30 minutes and 1 day respectively). A significant lower IOP measures were found in the Prophylactic group compared to unprophylactic group A after 30 minutes and 1 day post injection (mean IOP of 16.56 ± 2.68 and15.12 ±1.99 at 30 minutes and 1 day respectively) (p value less than 0.05).
Conclusion: Topical brimonidine prophylaxis can effectively reduce intraocular pressure (IOP) spikes following intravitreal injection of Ranibizumab (Lucentis) 0.5mg/0.05ml.